Dietlein T. S., Jacobi P. C., Krieglstein G. K.

Dept. Ophthalmology, University of Cologne, Joseph-Stelzmann-Str. 9, 50931 Köln

Background: Grid-laser trabeculectomy is a modification of microtrabeculectomy in order to enhance intra- and postoperative safety of filtering surgery by creating several small fistulas (< 200 µm) beneath a scleral flap without a peripheral iridectomy.
Methods: After dissecting conjunctiva and a conventional scleral flap 10 small perforating fistulas were created in 5 pigmented rabbits in the region of the grey-white border by using an Erbium:YAG laser with a beveled sidefiring 200 µm endoprobe; conventional trabeculectomy with iridectomy was performed in another 5 animals. Anterior chamber inspection and IOP measurements of both eyes were conducted on postop. day 1, 4 and 14. After the last inspection eyes were saved for morphological analysis.
Results: By both procedures (grid-laser/conventional TE) intraocular pressure (IOP) of the treated eye could be reduced compared to the control eye on postoperative day 1 (-8.0 mmHg / -7.8 mmHg), 4 (-2.4 mmHg / -3.1 mmHg) and 14 (-2.2 mmHg / -0.4 mmHg). Differences between both methods were not statistically significant. Morphology of the eyes treated by grid-laser trabeculectomy revealed dense scarring of perforations centrally to the pectina ligamenta and loose tissue refilling of the openings more peripherally.
Conclusions: Grid-laser trabeculectomy showed similar functional outcome in rabbits as conventional trabeculectomy in short terms. Considering histology after 2 weeks micro-perforations in the area of the trabecular meshwork suggest less pronounced tissue repair than perforations more anteriorly. This morphologic finding may also be of importance for non-penetrating glaucoma surgery.

Copyright © Deutsche Ophthalmologische Gesellschaft, 2001. All rights reserved.

Last updated: 

Webdesign: SPALLEK.COM